Mixed pain, defined by the concurrent involvement of nociceptive, neuropathic, and sometimes nociplastic mechanisms, poses a significant diagnostic and therapeutic challenge within modern pain medicine. This complex pain phenotype is increasingly recognized as a prevalent and burdensome clinical entity, yet it remains substantially underdiagnosed and sub-optimally managed across diverse healthcare settings. Epidemiological data indicate that mixed pain affects a substantial proportion of patients with chronic pain syndromes and is consistently associated with more severe symptomatology, prolonged pain duration, functional impairment, diminished quality of life, and escalated healthcare resource utilization compared to pain of a single mechanism. In response to this unmet clinical need, the present recommendations aim to provide a structured, evidence-informed framework for the diagnosis and management of mixed pain. Developed through a rigorous process involving systematic literature review and multidisciplinary expert consensus, this document emphasizes the importance of mechanism-based therapeutic strategies tailored to the individual patient’s pain profile. Central to the approach is the implementation of multimodal and interdisciplinary care models that address the biological, psychological, and functional dimensions of mixed pain. These recommendations are intended for a broad spectrum of healthcare professionals, including primary care physicians, pain specialists, neurologists, oncologists, physiatrists, nurses, pharmacists, physical and occupational therapists, and clinical psychologists. The target population encompasses patients affected by mixed pain conditions such as chronic low back pain with radiculopathy, cancer-related pain, persistent post-surgical pain, and osteoarthritis complicated by central sensitization. By facilitating accurate diagnosis and integrated treatment planning, these recommendations seek to advance clinical practice, reduce the burden of mixed pain, and enhance patient-centered outcomes. This guidance aims to transform mixed pain care by promoting mechanism-based, multidisciplinary strategies with direct clinical applicability.
The ability of single and mixed bacterial culture to utilize Dora-refineries petroleum wastes was compared. Pseudomonas aeruginosa and Serratia ficaria mixed culture consumed the wastes better than the single bacterial cultures. The highest log. number of viable cells in mixed culture was 6.842 , while in single bacterial cultures it was 6.683 and 5.631, respectively. after 3 days in API medium containing the refinery wastes. The effect of some environmental conditions on the degradation of petroleum wastes was studied included aeration , NaCl concentration , pH and temperature. The growth of bacteria in the agitated culture was higher than stagnant culture the log. of cell no. was 6.021 in the first culture. The h
... Show MoreMixed metal ligand complexes is reported with Curcumin (CUM) as a primary ligand and 1:10-phenanthroline (phen ) as secondary ligand. The structures of these complexes are confirmed by using FT-IR and UV- electronic spectroscopies, magnetic moments, melting points , molar conductivity measurements .and the metal % analysis revealed that the complexes analyze indicates a six coordinated as[M(CUM)( Phen)2]Cl, M=Mn (II), Co(II), Ni(II),Cu(II) ,Zn(II) , Cd(II) , Hg(II) and [M’ (CUM)( Phen)2]Cl2 M’= Cr(III) &. Fe(III). In-vitro antimicrobial studies on ( Curcumin and 1:10-phenanthroline ligands and mixed metal ligand complexes against {(Bacillus subtilis (G+) , Esherichia Coli (G-) and as well as antifungal activities against Candida albican
... Show MoreIn this work, lanthanium (III) complexes were synthesized using by Schiff base ligand (L) derived from benzaldehyde and o-aminoaniline with five amino acids (AA) from glycine (Gly), L-alanine (Ala), L-valine (Val), L-asparagine (Asp) and DL- phenylalanine (Phe). The Schiff base ligand has been characterized by elemental analysis, (MASS, FTIR, 1HNMR, 13CNMR, UV-VIS) electronic spectra. The structures of the new complexes have been described of analysis of elements, molar conductivity, (UV-Vis electronic, FTIR, mass) spectra also magnetic moment. The molar conductivity values of the complexes indicat this every of complexes are electrolytes and other analytical studies reveal octahedral geometry for La (III) ion. The Schiff base ligand, five
... Show MoreMixed Kirkuk and Sharki-Baghdad crude oils were distilled into narrow fractions. The range of these narrow fractions were 10oC, starting from IBP to 350oC. The total distillates from mixed Kirkuk and Sharki-Baghdad crude oils were 58.25 vol % and 44.65 vol %, respectively.The hydrocarbons compositions (paraffin, naphthene, aromatic) in light fractions starting from IBP to 250oC were determined by using PONA analysis method. The results show that the paraffin content decreases with increasing mid percent boiling point of the fraction, while the naphthene, and aromatic increase with the increase of mid percent boiling point of mixed Kirkuk and Sharki-Baghdad crude oils. Three groups of empirical equations were developed for the prediction
... Show MoreSteel Reinforced Concrete (RC) frequently faces durability problems. In certain areas, Glass Fiber-Reinforced Polymer (GFRP) rebars are considered a non-corrodible substitute for steel reinforcement. Elevated temperatures have a significant impact on the mechanical characteristics and the adhesiveness of GFRP rebars to concrete, particularly when the polymeric matrix's glass transition temperature is approached or surpassed. Three simply supported reinforced concrete slabs were considered in the experimental program. Each specimen had identical dimensions of 1500×540×120 mm. For the fire resistance requirements, a 45 mm clear concrete cover and an exception of a 200 mm unexposed (cool) anchor zone at the ends were considered. The
... Show MoreBackground: Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic process often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. Various instruments have been described to perform atraumatic extractions which can prevent damage to the paradental structures. The physics forceps is one of those innovations in dental extraction technologies that claim to provide an efficient means for atraumatic dental extractions. Materials and method: A randomized clinical trial was conducted to compare the physics forceps with the conventional forceps for the removal of 28 mandibular single rooted teeth under the following parameters: incidence of crown, root, b
... Show MoreBackground: The aim of this study was for estimation and comparism of masticatory efficiency in patient wearing heat cured acrylic and flexible base partial denture, finding out the role of peanuts and carrots on the measurement of chewing efficiency, and to find out whether the types of P.D. (being single or two opposing each other) has any effect on the masticatory performance. Materials and methods: Twenty partially edentulous patients were selected. Five of these patients were selected having Kennedy class I with no modification against natural dentition, other 5patients having Cl.I against Cl.I . The other 5 patients having Cl.III against natural dentition and the last 5 patients were with Cl.III against Cl.III. several ways were used
... Show MoreBackground: COVID-19 is an ongoing disease that caused, and still causes, many challenges for humanity. In fact, COVID-19 death cases reached more than 4.5 million by the end of August 2021, although an improvement in the medical treatments and pharmaceutical protocols was obtained, and many vaccines were released. Objective: To, statistically, analyze the data of COVID-19 patients at Alshifaa Healthcare Center (Baghdad, Iraq). Methods: In this work, a statistical analysis was conducted on data included the total number, positive cases, and negative cases of people tested for COVID-19 at the Alshifaa Healthcare Center/Baghdad for the period 1 September – 31 December 2020. The number of people who got the test was 1080, where 424 w
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